Acetabular erosion is a common longterm complication of hemiarthroplasty. Chondrolysis of the hip secondary to severe trauma, prolonged immobilization and slipped capital. Patient who are most at risk for developing chondrolysis are those who present with a joint injury, says dr. Coronal t1weighted image trte, 35022 of pelvis shows geographic focus of abnormal signal intensity in. Chondrolysis of the hip was first described in the early 1900s. Combined femoral and pelvic osteotomies versus femoral osteotomy alone in the treatment of hip dysplasia in. Chondrolysis uw orthopaedics and sports medicine, seattle. The authors stress the causes why a disease with characteristic clinical and radiographic appearances and normal biochemical findings presents diagnostic difficulties.
For this reason she was transferred to our department. The symptoms of postarthroscopic glenohumeral chondrolysis typically occur months after the individual has undergone a surgical procedure known as shoulder arthroscopy. Idiopathic chondrolysis of the hip skeletal radiol. Chondrolysis of the glenohumeral joint after arthroscopy. Hip radiography showed a concentric decrease of joint space and. Idiopathic chondrolysis of the hip annals of the rheumatic diseases. An unusual case of chondrolysis of the hip following excision of a. Despite speculation among clinicians and researchers about the implicit causal pathways and etiologic contributors associated with chondrolysis, definitive answers remain elusive. Claire leblanc, kristin houghton, in textbook of pediatric rheumatology seventh edition, 2016.
Case report idiopathic chondrolysis of the hip a case report. All four patients met the radiological criteria for rapid chondrolysis defined for the hip 2. Acute chondrolysis complicating slipped capital femoral. Idiopathic chondrolysis of the hip is characterized by pain and limp in adolescence, with progressive loss of articular cartilage space and stiffness of the hip. During shoulder arthroscopy, the joint of the shoulder is examined, and possibly operated on, using a miniature camera, lighting equipment, and surgical tools. Upload your pdfs in our premium pdf to word converter online. Idiopathic chondrolysis of the hip ich was first reported by jones in 1971 with clinical records of 9 patients aged between 9 and 16 years 1. It may be idiopathic jones 1971 or secondary to underlying conditions, such as slipped capital femoral epiphysis scfe, intraarticular penetration of scfe pins, infection, inflammatory arthritis, prolonged. Although the disease was first described in the hip, reports of chondrolysis in nearly all diarthrodial joints have since emerged with considerable variations in the literature.
In the hip joint, the injury is often a trauma resulting in hip fracture or in association with various developmental conditions of the growth plate. To the best of our knowledge, no case of medial femorotibial compartment chondrolysis after arthroscopy has yet been described. Chondrolysis of the hip is a disorder most frequently seen in children who have suffered with slipped capital femoral epiphyses. Downloaded free from on thursday, june 28, 2018, ip. These certificate pages are easy to download and print. In 1930 the first case of hip chondrolysis was reported by waldenstrom 1. Historically, chondrolysis was mostly associated with the hip as an idiopathic disorder in the developing hip5 or associated with slipped capital epiphysis. Cartilage space width in slipped capital femoral epiphysis core. Chondrolysis of the hip secondary to severe trauma, prolonged immobilization and slipped capital femoral epiphysis have been well documented. Earlyonset osteoarthritis originates at the chondrocyte level in hip.
Four cases of idiopathic chondrolysis of the hip in three white girls and one maori girl are reported. Chondrolysis of the hip in a female adolescent with marfans. Chondrolysis occurs in children as well as in adults 2. Open source resource, download royalty free audio music mp3 tracks free for commercial use no attribution required. Chondrolysis has been reported among adolescent females after slipped capital femoral epiphysis 3.
Chondrolysis of the hip secondary to severe trauma, prolonged immobilization and slipped capital femoral epiphysis have. Magnetic resonance imaging of the hip demonstrates cartilage loss, joint effusion, marrow edema, femoral and acetabular remodeling, significant. Jun 16, 2019 chondrolysis of the hip in an adolescent. Pain, motion range limitation, and radiographic joint space narrowing are the main manifestations. David department of orthopaedics, christian medical college hospital, vellore, india background. The risk of chondrolysis is increased when local anesthetics either bupivacaine marcaine or lidocaine xylocaine are infused into the joint for postoperative. Rapidly destructive osteoarthritis of the hip and rapid chondrolysis of the lateral compartment of the knee or the shoulder are rare, but have been previously described in the medical literature. Nine patients with chondrolysis secondary to slipped capital femoral epiphysis of the hip were followed up from a minimum of 7 to a maximum of 19 years average. The etiology remains unknown, although many pathogenetic mechanisms have been suggested, including a generalized connective tissue disorder. This entity, subsequently termed idiopathic chondrolysis, typically presents in preadolescents or adolescents as a painful, stiff hip. Idiopathic chondrolysis of the hip is extremely rare and to our knowledge, its onset has never been documented in adults aged over 20. Idiopathic chondrolysis of the hip gupta s, choudhary mm j orthop. Initially, chondrolysis was identified in patients following slipped capital femoral epiphysis 1.
All were treated by extensive softtissue release but in no case did this improve movement of the affected hip and permanent stiffness was the. Chondrolysis of the hip in a female adolescent with marfan. Subjects with developmental dysplasia of the hip ddh often show earlyonset osteoarthritis oa. Association with trauma and burns, infection, and prolonged immobilization have also been described. Jul 01, 20 chondrolysis is a severe type of shoulder arthritis in which the cartilage of the joint is abruptly lost. Rapid acetabular chondrolysis following hemiarthroplasty. With reference to the available medical literature, we summarise the current. Biochemical studies of articular cartilage retained at surgery revealed deposition of exclusively small proteoglycans in the matrix. Pdf idiopathic chondrolysis of the hip is a rare disorder characterized by pain, stiffness, limp and radiological loss of joint space of the affected. Idiopathic chondrolysis of the hip in children has been well documented in the literature. Oct 01, 2020 free, official coding info for 2021 icd10cm m94. Failure of nutrition of articular cartilage due to apaucity or complete lack of production of synovialfluid.
Chondrolysis is defined as rapidly progressive loss of articular cartilage from both the femoral and acetabular sides of the hip. She underwent hip arthroscopy to repair a degenerative labral tear, as well as radiofrequency debridement and microfracture of the exposed chondral defect, and femoral osteoplasty. Many paediatric conditions can lead to chondrolysis of the hip such as slipped. As opposed to idiopathic chondrolysis of hip, in infections the hip joint space is usually increased.
Despite speculation among clinicians and researchers about the implicit causal pathways and etiologic contributors associat. Idiopathic chondrolysis of the hip ich is commonly seen in adolescents and young children in the age group of 912 years with female predilection. During the following months the pain was minimal, but the motion was further reduced. Pdf 2005 idiopathic chondrolysis kenny david academia. Combined femoral and pelvic osteotomies versus femoral osteotomy alone in the treatment of hip dysplasia in children with cerebral palsy. Startzman as, hawkes t, beterand s juvenile idiopathic chondrolysis of the hip. Other suggested risk factors include trauma, infections, and prolonged.
There have not been many reports, however, of idiopathic chondrolysis of the hip. Online file sharing and storage 15 gb free web space. Coronal t1weighted image trte, 35022 of pelvis shows geographic focus of abnormal signal intensity in proximal left femoral epiphysis arrow. Usually occurring 12 months to 18 months after some insult, such as surgery, this condition most commonly follows after joint arthroscopy. The insidious nature of the symptoms and lack of early radiographic findings and diagnostic testing often. A geometric region of abnormal signal intensity centered in the proximal femoral epiphysis, accompanied by ipsilateral illdefined acetabular bone marrow edema, mild synovial hypertrophy, and minimal if any joint fluid, in a child with a painful stiff hip are early mri findings characteristic of idiopathic chondrolysis. She gradually became pain free, but the left hip progressively became stiffer despite the treatment. Acute idiopathic chondrolysis and primary acetabular protrusio may.
Etiology and implications related to the use of intraarticular local anesthetic introduction a devastating condition, chondrolysis is characterized by the disappearance of the joint. Usually occurring 12 months to 18 months after some insult. Rapid acetabular chondrolysis following hemiarthroplasty of. Many paediatric conditions can lead to chondrolysis of the hip such as slipped capital femoral epiphysis, perthes disease, trauma, immobilisation for a long time, infectiveinflammatory joint diseases and. Bilateral idiopathic chondrolysis of the hip request pdf. Apr 22, 20 characterized by an acute form of rapidlyprogressive chondrolysis occurring mostfrequently during adolescence withisolated involvement of the hip joint, butwithout a demonstrable cause. Chondrolysis following slipped capital femoral epiphysis. Idiopathic chondrolysis of the hip is a rare condition of unknown etiology characterized by progressive destruction of the hyaline cartilage that covers the femoral. Sequelae of septic arthritis of the hip in children. This condition has an insidious onset, and is observed more commonly in female preadolescents. Adult idiopathic chondrolysis of the hip report of two.
Chondrolysis is a devastating condition in which cell death of chondrocytes results in irreversible loss of articular cartilage and leads to rapidly progressive and extensive osteoarthritis of the joint. Chondrolysis of the hip complicating slipped capital femoral. Chondrolysis of the hip is a rare condition characterized by progressive destruction of the articular cartilage of the femoral head and the acetabulum. We here present our experience with 21 hips with an average follow. Pdf idiopathic chondrolysis of the hip is a rare disorder characterized by pain. Discussion jones8 reported the first cases of idiopathic chondrolysis of the hip in 1971, and a summary of this table i idiopathic chondrolysis of the hip female male numbers 33 825% 7 175% sex ratio 5 1 age range yr 918. Download as pdf print show related cases notify admin.
Chondrolysis of the hip pediatric orthopaedic society of. Chondrolysis of the hip is a rare disorder, characterized by progressive and rapid destruction of articular cartilage from both joint surfaces. It is most commonly unilateral, often seen involving the right joint. Fifteen of 18 cases who underwent conversion total hip prosthesis due to painful hemiarthroplasty, between 1992 and 1997, were investigated retrospectively. We present a case in which rapid acetabular erosion occurs within weeks of hemiarthroplasty, ultimately leading to an acetabular fracture and need for revision. The degree of slipping of the proximal epiphysis of the femur was severe in five patients and moderately severe in four patients. Rapidly destructive osteoarthritis of the hip and rapid chondrolysis of the lateral compartment of the knee or the shoulder are rare, but have. Chondrolysis of the hip joint in a patient receiving long. It may be idiopathic or secondary to other hip pathology, particularly scfe or lcp disease. Subtotal capsulectomy for idiopathic chondrolysis of the hip. Idiopathic chondrolysis of the hip is a rare disease in which gradual necrosis of the hyaline cartilage covering the femoral head and acetabulum leads to joint space narrowing and motion restriction. It is characterized by the rapidly progressive destruction of articular cartilage in the hip joint resulting in premature degeneration and subsequent joint arthrosis.
It can occur in otherwise healthy shoulders after arthroscopic procedures. The first case of idiopathic chondrolysis of the hip from southeast asia is. Rapid chondrolysis of the medial knee compartment after. Symptoms of postarthroscopic glenohumeral chondrolysis pagcl. Adultonset idiopathic chondrolysis of the hip springerlink. Amarnath, et al idiopathic chondrolysis of hip new. Monoarticular juvenile rheumatoid arthritis rarely affects the hip, and in the early stages, typically demonstrates a widened joint space with joint effusion, and an increased esr and creactive protein 38. Idiopathic chondrolysis of the hip ich is a rare condition of unknown etiology, and is characterized by rapid, progressive destruction of the articular cartilage in the coxofemoral joint. Idiopathic chondrolysis in adults treated with surgical. Two months after hip arthroscopy, hip pain and limping began. Once you upload the scanned word file, ocr will be activated. Idiopathic chondrolysis of the hip is a very rare disorder that occurs mostly in adolescents with fewer than cases documented. Severe osteoarthritis was demonstrated on physical examination, serial radiographs and magnetic resonance imaging.
Roentgenographically, cartilage necrosis, or chondrolysis, is diagnosed by nar. The roentgenographic findings and early symptoms may serve to warn the radiologist and clinician of the onset of chondrolysis. A presumed interruption in the synovial membrane of the hip joint was hypothesized to yield cartilage damage and death five to eight months following reduction of the slipped. Read chondrolysis of the hip joint in a patient receiving long.
Ich is characterized by pain and limp during adolescence, with progressive loss of articular cartilage space and stiffness of the hip 2. A devastating condition, chondrolysis is characterized by the disappearance of the joint. The chronic phase results in three different outcomes. The clinical outcome varies from complete recovery to severe ankylosis of the hip joint. Pdf idiopathic chondrolysis of the hip researchgate. Chondrolysis of the hip was first reported in 1930 and has been reported to involve the shoulder, hip, knee, and ankle. Patients report intense pain, motion restriction, and often. Only four cases of chondrolysis in solid organ recipients have been described in the literature. Results of conversion total hip prosthesis performed following. It is found in the 2021 version of the icd10 clinical modification cm and can be used in all hipaacovered transactions from oct 01, 2020 sep 30, 2021. Chondrolysis also known as acute cartilage necrosis, is a rare disease with destruction of cartilage of joints such as hip, knee, ankle, shoulder and elbow 1. Idiopathic chondrolysis of the hip ich is a rare condition, occurring mostly in black female adolescence.
Sherry, in textbook of pediatric rheumatology fifth edition, 2005 acute chondrolysis of the hip. Foxit software is the reliable source for fast, affordable, and secure pdf solutions. Introduction very rare characterized by the destruction of articular cartilage due to an unknown cause, principally affecting women during adolescence and producing premature degeneration of hip. Sheck 3 used the width of the joint to help identifyroentgenographic evidence of hip. Acute chondrolysis of the hip is an unusual condition in which there is an insidious onset of hip pain and limitation of movement in association with radiographic evidence of progressive loss of articular cartilage. A 32yearold woman with bilateral hip chondrolysis diagnosed 2 years following allogeneic liver transplantation is described. Chondrolysis of the hip is characterized by pain and limp due to progressive loss of articular cartilage space by an undefined but presumed inflammatory process. We report the case of a 23yearold man diagnosed with adultonset idiopathic chondrolysis of the hip. Rapid multifocal chondrolysis after liver transplantation in. When conversion finished and then you can click on download.
Idiopathic hip chondrolysis is a rare disorder, the pathophysiology of which has not been fully. Both hemiarthroplasty and total hip arthroplasty have been well described as effective methods of management for displaced femoral neck fractures in the elderly. The affected hip has a good range of pain free movement, similar to that of his unaffected hip. Patient presented with left hip pain and stiffness of 3 weeks duration.
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